Conectar
There is limited research exploring the age-related difference in communication when describing pain experiences. This project aimed to identify key differences between adolescents’, young adults’ and adults’ (i) preferred communication method, (ii) language content and (iii) lexical amount and variety when discussing their persistent pain experience using chatbot technology.
An exploratory concurrent nested mixed-methods design using a comparative analysis.
Participants were recruited through a convenience sampling strategy from two tertiary multidisciplinary pain centres in Australia.
20 adolescents, 20 young adults and 20 adults completed a pain history assessment using the Dolores application. The inclusion criteria for this study were (i) persistent non-cancer pain for at least 3 months, (ii) 10 years of age and over and (iii) adequate expressive and receptive language skills to complete the required tasks in English, as determined by clinicians in the treating team.
Drawn, voice and typed responses provided by participants during the chatbot interaction were analysed using content analysis. Fisher’s exact tests and 2 tests were used to examine differences between age groups. Strong effect size estimates generated from comparative analyses suggested that adolescents were the most likely age group to utilise drawing (p=0.153, Cramer’s V=0.268), preferred typing over speaking (p==0.007, Cramer’s V=0.433). Young adults used the greatest number and variety of words in response to chatbot questions including evaluative language (p=0.097, Cramer’s V=0.296). Adults tended to use more metaphors (p=0.085, Cramer’s V=0.305) and had a strong preference for speaking over typing (p=
The results of this study provide insights into age-related differences in communication and preferences when using technology to communicate about persistent pain. Future research exploring individualised age-related approaches to pain assessment, supported by the findings of this study, in comparison to current standardised assessments administered by clinicians are warranted.
Heart failure (HF) is a debilitating condition associated with high morbidity, mortality and healthcare resource use. Frailty in HF patients is associated with poorer outcomes, including increased morbidity, mortality and reduced quality of life (QoL). Nutritional disorders, such as malnutrition, are common in patients with HF and contribute to functional decline and increased mortality. The Meta-Analysis Global Group in Chronic HF (MAGGIC) risk score was developed to predict 1-year and 3-year hospitalization and mortality in patients with HF. This study aims to assess the added value of frailty, QoL and nutritional status to the MAGGIC risk score.
This prospective cohort study, conducted at a tertiary public hospital in southern Brazil, will include 316 patients with chronic HF who are followed up at the HF Outpatient Clinic. Frailty will be assessed using the Fried scale, health-related QoL will be assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and nutritional status will be assessed using the Mini Nutritional Assessment. These variables will be incorporated into the MAGGIC risk score. Continuous variables with a normal distribution will be described as mean±SD, skewed variables as median±IQR and categorical variables as absolute and relative frequencies. Survival analysis will be performed using the Kaplan-Meier method with log-rank test comparisons. The prognostic value of frailty, its components, the MLHFQ score and nutritional status will be assessed by Cox regression, which will be adjusted for the MAGGIC risk score. Net Reclassification Improvement and Integrated Discrimination Improvement will assess the accuracy of the MAGGIC score when including frailty, MLHFQ and nutritional status. A p value
This study adheres to the Declaration of Helsinki and was approved by the Institutional Committee for Scientific Ethics and Research (No 20220558) and the Brazilian Government Registry (No 66474223200005327). The data will be available on reasonable request from the corresponding author. The results will be disseminated via peer-reviewed manuscripts and shown at national and international conferences.
Standardised triage systems have been in place for decades with minor modifications, while nurses' skills and knowledge have significantly advanced.
To determine whether nurses' clinical expertise outperforms triage systems in simulated clinical cases.
A multicenter simulated observational study.
The study was conducted from January 1, 2024 to March 31, 2024, in four Italian emergency departments, enrolling triage-performing nurses. Thirty clinical cases, based on real patients representing daily emergency department influx, were reconstructed. The primary outcome was the agreement between the triage code assigned by the Manchester Triage System and the code assigned based on clinical expertise. The secondary outcome compared the predictive ability of the codes assigned by nurses regarding clinical outcomes, such as death within 72 h, the need for hospitalisation, and the need for life-saving intervention. The study was reported in accordance with the STROBE statement.
Seventy-seven triage nurses completed the 30 vignettes. The agreement between the MTS-assigned code and the clinical expertise triage reported a Cohen's kappa of 0.576 (95% CI: 0.564–0.598). For death within 72 h, the clinical expertise code reported better results than the Manchester Triage System. For life-saving interventions, the Manchester Triage System reported a lower performance than clinical expertise. The variability in triage code assignment was higher for clinical expertise compared to the Manchester Triage System.
Triage codes assigned by nurses based on clinical expertise perform better in terms of clinical outcomes, suggesting a need to update triage systems to incorporate nurses' knowledge and skills. However, standardised triage systems should be maintained to reduce variability and ensure consistent patient classification.
The study was conducted and reported according to the STROBE statement.
No patient or public contribution.
FreshRSS